Starosta A D, Ehler J, Löffler B, Tannapfel A, Zipprich A, Reuken P A, Stallmach A
Department of Internal Medicine III (Nephrology, Rheumatology, Endocrinology), Jena University Hospital - Friedrich Schiller University, Jena, Germany.
Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Infection. 2025 Feb 5. doi: 10.1007/s15010-025-02479-y.
Enterovirus infection has been described as a cause of severe viral sepsis in humorally immunosuppressed patients.
A 20-year-old female with a history of multiple sclerosis on ocrelizumab therapy with persistent agammaglobulinemia and autoimmune hepatitis treated with azathioprine/budesonide presented with subacute sensorineural hearing loss, hepatitis, pneumonia, enterocolitis and pancreatitis. Molecular pathological techniques detected enterovirus RNA in samples from the liver, blood, ascites fluid, and pleural effusions, confirming Echovirus serotype 11. The case was managed successfully with supportive care and high-dose intravenous immunoglobulins in addition to fluoxetine.
This patient's unique presentation and clinical course presents important implications for the care of immunosuppressed patients with cryptic complaints.
肠道病毒感染已被描述为体液免疫抑制患者严重病毒败血症的一个病因。
一名20岁女性，有多发性硬化病史，正在接受奥瑞珠单抗治疗，伴有持续性无丙种球蛋白血症和自身免疫性肝炎，接受硫唑嘌呤/布地奈德治疗，出现亚急性感音神经性听力损失、肝炎、肺炎、小肠结肠炎和胰腺炎。分子病理学技术在肝脏、血液、腹水和胸腔积液样本中检测到肠道病毒RNA，确诊为艾柯病毒11型。除氟西汀外，该病例通过支持治疗和大剂量静脉注射免疫球蛋白成功治愈。
该患者独特的表现和临床过程对隐匿性症状的免疫抑制患者的护理具有重要意义。
